セカンドブレイン―腸にも脳がある! 単行本 – 2000/3
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WHATEVER YOU DO, DO NOT HAVE GASTRIC BYPASS SURGERY UNTIL YOU READ THIS BOOK! You might just change your mind about that surgery after reading this.
I began reading it after my gastroparesis diagnosis in 2013. For those who aren't aware: gastroparesis literally means "paralyzed stomach". What goes in, stays in, and doesn't always come out. There's no cure; it's only symptom management, and it's lousy, at best. So I decided to learn about how the stomach functions.
This book is written by a GI doctor. He's one of the researchers who brought Pepcid to the market. (thank you!) Through his research, he began to believe that the digestive system functions totally autonomously from the brain & central nervous system. He calls it the "enteric nervous system". His research has taken him into neurology.
He writes in plain English; he's not selling anything. This is an objective, scientific, yet understandable blow by blow of how your enteric nervous system works. He uses medical terms, translates them, uses pictures, and is very easy to understand. He can be dry, but even for me, who is not normally excited over science, this is fascinating. I had no idea how many different functions that the stomach does, and nowhere else in the body are these functions duplicated.
I'm not finished the book, but it's helping me to understand how my stomach is supposed to work. Maybe once I know HOW it should work, I might better be support my stomach function better now that a part of it doesn't function like it should anymore. I now highly recommend this to everyone I know who has stomach or intestinal distress.
Gershon's book is a nice mixture of an autobiography and science book that remains detailed and scientific without becoming daunting like a high-level neuroscience textbook. Though some sections of the book are fairly technical, all of it is understandable by a focused reader or by someone with a moderate background in neuroscience or biology. Gershon's personal stories range from pedestrian to fascinating, while his anatomical and physiological explanations are usually comprehensive while remaining comprehensible.
The book is split up into three sections. Part I provides the background of both Dr. Gershon and the field of neurogastroenterology, along with a basic overview of how the relevant sections of the nervous system work. Part II is a comprehensive guide to the digestive tract, providing a "mouth-to-anus travelogue of the inner sanctum of the gut" in Gershon's own words. Part III focuses on modern day research (or rather, research that was modern in 1998) on the development and disorders of the second brain. Each part is written in the same style, with Gershon's personal stories and review of scientific research split amongst the four chapters in each of the three parts.
Part I - The Early Breakthroughs
Dr. Gershon starts his book with modesty not commonly seen in authors. Gershon is commonly credited as being the "Father of Neurogastroenterology," but for most of the first section of his book he describes the just how wrong that title is. The true fathers of neurogastroenterology date back to Bayliss and Starling, over a hundred years before Gershon's rediscovery of the subject. In Gershon's own words, "Rediscovery is very bit as good as discovery, if what is rediscovered is important and was forgotten." Gershon describes the origin of the field through the tales of the scientists who came before the creation of the term "neurogastroenterology," including J. N. Langley, the discoverer of the autonomic nervous system. Much of the remainder of the first section goes into the study of the neurotransmitters of the intestines, especially serotonin. The prevalence of serotonin, a neurotransmitter commonly known for regulating mood and sleep patterns, was of particular interest to neurobiologists such as Gershon. Serotonin is essentially what inspired him to further his research into the neurological systems of the gut.
Part II - The Travelogue
The second section of Dr. Gershon's book contains a comprehensive guide to the entire digestive tract, analyzing both the structure and the functions of each of the major players in digestion from the mouth to the anus. Much of the information covered is on the level of a basic anatomy textbook, with several asides about the physiological bases of gastrointestinal diseases or abnormalities. As the section goes on, the level of detail becomes increasingly greater, eventually becoming an entire miniaturized textbook on the digestive tract. Gershon impressively ties everything together by explaining that much of the pathological origins of digestional problems come not from the organs themselves, but from the neurological tracts of the enteric nervous system that comprise the second brain.
Part III - The Origin of the Second Brain and Its Disorders
The final section of Dr. Gershon's book ties form and function together to explain how current research is progressing towards the understanding and treating of various gastrointestinal diseases. Gershon details the experiments he and select other scientists have performed on various parts of the intestines in order to heighten the understanding of both the enteric nervous system and the diseases associated with it. This is by far the most technical and detailed portion of the book, and somewhat of a chore to go through for anyone not enamored with the material. In the endnote of the book, Gershon reveals somewhat of a somber personal story from his deceased father, who repeatedly asked of Gershon's work: "So, Michael, what disease is that going to cure?" The answer, at least in regards to this book, is sadly nothing. However, Gershon has great hope that his book will help further the general understanding of the enteric nervous system and the second brain, in hopes that it will help kindle the enthusiasm amongst young students and aspiring neurobiologists alike.
As a reader without a degree in biology or neuroscience, I was still captivated by The Second Brain. Gershon's technical writing clear enough to be understood without cutting material, and his diagrams and drawings help illustrate what text alone has trouble explaining. His personal stories about the politics of neuroscience and detailed historical overview on the scientists that came before him are both interesting and on topic, and are spread throughout the book to avoid the monotone of modern-day textbooks by dividing the boring parts of the book with something a little more interesting. Gershon manages to do all of this in a way that lets you see into the author's head itself. His passion for the subject and concern over gastrointestinal disease sufferers is very apparent from his writing.
If anyone interested in neuroscience or the enteric nervous system is thinking about purchasing it, I would definitely highly recommend giving it a read. This is not a self-help book or a guide to dealing with nervous disorders of the gut, but instead a guide to learning about the connections between the nervous and gastric systems. It is also not exactly an easy book to read; anyone without prior knowledge of the material has to be diligent and focused when reading, so as to not be overwhelmed by the onslaught of new terms and acronyms being thrown at them. Getting past that, the book is highly informative and certainly worth reading. I would definitely recommend it to anyone with a devoted interest into neurology, or any student in the field of neuroscience or neurobiology.
The book is often technicial but very approachable for the layperson. He provides a concise review of how digestion works from mouth to anus. I never thought about but apparently the nerves in the anus are sensitive enough to differentiate between gas and feces. The take home thesis is that the gut is as complex in many ways as the brain, the same neurotransmitters are at play in the GI tract, and it can operate quite well completely independently of the brain. In fact a brain responding to stress has a very negative impact upon the gut.
The book falls short in the area of practical applications. There is the suggestion that long term use of SSRI or proton pump inhibitors might impair the complex funtioning of the gut. However, I would like to know more about the behavioral interventions that might impact gut, such as diet, exercise and the use of meditation, relaxation, psychotherapy, or even imagery and hypnosis. In other words, the mind messes with the gut. Now what do we do about it?
This book is valuable for the lay person and for the medical professional.